Lincoln Park Chicago mental health facility Clayton Residential Home struggles with lack of Illinois state budget(0)
August 13, 2015
2026 Clark St., Chicago, IL 60614
“There’s no way that we could exist without a budget,” worried Jessica Lyke, the executive director of Clayton Residential Home, a specialized mental health and rehabilitation facility (SMHRF) for adults with mental illness.
Illinois recently entered its second month without a state budget; state lawmakers failed to approve a balanced budget before the start of the 2016 fiscal year on July 1. State funded programs like Clayton will still receive funding for the next couple months, only because the state is behind in sending payments to the facilities. But beyond that, everything is uncertain.
On Tuesday, August 4, the Illinois Senate approved a plan that would free up nearly $5 billion for various programs affected by the budget stalemate, including, among a long list of other items, SMHRFs. After some amendment, it was approved by the House on Wednesday, and must go back through the Senate before making it to Governor Rauner’s desk.
But this plan still only constitutes temporary relief for some facilities. If no permanent budget is put in place, funding to many state programs could stop altogether. If a budget is passed, there is no guarantee that Clayton will get the funding it needs. Governor Rauner’s original proposed budget would cut $82 million from the Department of Human Services’ Division on Mental Health, as well as $1.5 billion from Medicaid.
“Right now the governor wants to give us zero,” Lyke said. “He wants to cut us out of the budget.”
Clayton provides specialized programming and 24-hour care for more than 200 people with severe mental illnesses, about 5% of the mentally ill population in Illinois. Its activities encourage residents to learn about their illnesses, treatment options, and wellness. It also provides practical skills to help residents stabilize and re-enter the Chicago community. Residents have the opportunity to participate in more than 45 different groups including therapy sessions, cooking and laundry classes, and expeditions around the city.
“There’s a lot of focus here on recovery and wellness, instead of trying to focus on illness and symptoms and problems,” said Lyke.
“Some of the things that we provide are required by the state law,” said Lyke, including nursing, dietary, and security standards. “What Clayton does… is go well beyond what the state requires, and that obviously costs money.”
Lyke said that Clayton has six employees with clinical licenses, though the state does not require any. Their specialty programming, including the groups and activities listed above, are not specifically required by the state, but are things Lyke believes are essential to the residents’ experience at Clayton.
“Those are things that we’re very committed to keeping, but obviously if we don’t have money, those will be the things that will eventually have to go,” Lyke said.
Arnie Kanter, the senior director of external affairs for Barton Management, the parent group that oversees Clayton and several other facilities, pointed out that their care model is more cost effective than alternatives. The state pays Clayton $110 a day total, compared to the approximately $800 a day that an emergency hospitalization would cost for each patient. With this money, Clayton is able to provide much more personalized and comprehensive care than hospitalization. Other alternatives, such as nursing home placement or time in jail, also cost the state money.
“We become not only a programmatic effective facility, but also a cost effective facility,” Kanter said. “Everyone understands that folks with mental illnesses are high utilizers of services.”
Through peer and administrative support, each Clayton resident gets personalized care to match their needs and wellness goals.
“No two people with schizophrenia look alike, no two people with depression look alike,” Lyke said, adding that oftentimes residents have never had a chance to fully learn about their illness and symptoms before Clayton. “It’s really an opportunity to sit down and take that individualized approach with somebody and help them figure it out.”
The administration at Clayton and at other SMHRFs across the state are worried about whether they can continue providing these extensive services, which they see as essential, in the face of the budget impasse. In May, Clayton staff put together a YouTube video to help raise awareness for their facility, show what it means to its residents, and ask the community for help.
“I’m getting day-to-day support, I have people I can trust and turn to in times of trouble, and I average about 2 hospitalizations every 3 years now, as opposed to one every two weeks,” said Andy S., a Clayton resident, in the YouTube video.
People like Andy rely on Clayton for the support that they need to survive. If the facility shuts down, its 200 residents will have limited options. Some will wind up in nursing homes that are not equipped to care for their illnesses and where they will be a disturbance to other nursing home residents. Some will move back in with their families, who seldom have the time or know-how to support their loved ones. Others will end up on the streets, and could easily fall victim to crimes or be picked up by the police. Residents and their families are terrified of what will happen if no budget is secured for Clayton in the coming months.
“We got hundreds of letters from people, and people testified in Springfield saying ‘If it weren’t for a facility like Clayton, my loved one would be dead, my loved one would be in jail, my loved one would be dying of alcoholism or drug addiction, my loved one would be living on the streets,” Lyke said of the response Clayton got when talks first began about cutting funding for SMHRFs.
Lyke said that statements have been made year after year in the state government claiming that SMHRFs like Clayton limit the freedoms of their residents. Many of these came in 2011, after a consent decree was passed in the class action lawsuit Williams v Quinn, which essentially makes it easier for SMHRF residents to leave facilities like Clayton and re-enter their communities.
“This has been on the table for almost as long as I’ve been here,” said Lyke, who has directed Clayton for two years and before that worked as the clinical director for six years. “There were a lot of statements being made… that nobody needed to live in a place like this, and places like this should be shut down. We’re warehouses, we don’t provide any services for people, we’re just trying to make money off of people. I took that very personally.”
Despite their intent to keep serving their residents in the face of this opposition, Clayton has already had to tighten its belt to handle the effects of the budget impasse.
“Right now we’re making small changes. We’re not cutting anybody, but we’re not hiring anybody extra. We’re looking at ways to save money in every department,” Lyke said, including finding more affordable supplies, food, activities, and outings. She said if no funding is secured, Clayton would stay open as long as possible in order to help their 200 residents find places to go. Clayton’s closing would also spell unemployment for the facility’s 125 employees.
“Clayton provides structure, and support, and safety, and supervision that is necessary,” Lyke said. “We don’t intend to shut down. We don’t want to panic people.”
Lyke said she hopes that state lawmakers will eventually see that the services Clayton and other mental health facilities provide is necessary and worth funding. In addition, she hopes that lawmakers begin to see the value in the people utilizing their facilities.
“My hope as an altruistic dreamer is that our worth and value will be recognized as an extremely important part of the continuum of care for mental health needs in Illinois,” Lyke said. “The people who live here aren’t being valued. What it is that they need, and what it is that’s going to be helpful for them is overlooked because they’re not taken seriously. They’re not seen as something that’s worth funding.”
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